Physicians sounding the alarm on prior authorization: 9 things to know

Physicians are feeling increasingly burdened by prior authorization requirements, according to Medscape's 2024 "'They're Awful and Impede Patient Care': Medscape Physicians and Prior Authorizations Report 2024."

The survey collected responses from 1,073 physicians between March 1 and May 26, 2024. 

Here are nine key takeaways from the survey:

1. Physicians are spending more time on prior authorizations. Approximately 2 in 3 physicians said that they spent slightly more time (39%) or much more time (27%) on prior authorizations now than they did three years ago. Around 80% of physicians in the survey also said that medical staff are spending more or much more time on prior authorizations than they were three years ago. 

2. Physicians think that the cost of prior authorizations is rising. More than 7 in 10 physicians told Medscape that they believe the cost of prior authorizations are higher or much higher than they were three years ago. 

3. Most physicians think that too many services and medications require prior authorization. Almost 9 in 10 physicians (89%) said that payers attach a prior authorization to too many treatments or medications. 

4.  Physicians support uniformity among government and private payers. When given options of different reforms for prior authorization procedures, 51% said that they supported uniformity among payers. Another 19% said that greater automation on the provider's end would help, 12% supported a central database of procedures, and another 8% and 9% supported more e-filing options from payers and other options, respectively. 

5. Prior authorizations are interfering with patient care. The vast majority (86%) said that the time spent processing prior authorization requests or appealing denials often delayed patient care. Another 61% said that patients frequently abandoned suggested treatments because of prior authorization delays. 

6. Prior authorization processes are also confusing. When asked how difficult it was to grasp prior authorization forms and requests on a scale of one to five, with 1 being very difficult and  5 being very easy, 20% of physicians responded and selected "1." Another 34% and 35% selected "2" and "3", respectively.

7. Some lack the staffing to handle prior authorization burdens. Fifty-eight percent of physicians said that they did not have enough staff to handle prior authorizations. 

8. More efficiency is needed on medical staff. When asked if their support staff needed to become more efficient in processing prior authorizations, 57% said yes. Another 25% disagreed, while 18% were unsure. 

9. Physicians are supportive of the new federal rule regarding prior authorizations. In January, CMS finalized a rule to streamline prior authorization processes that will take effect in 2026. About 9 in 10 physicians said that the rule will be at least somewhat helpful to their practices, and one in four said it will be very helpful. 

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